What Separates Medical Aesthetics from Retail Aesthetics with Dominic Mazzone of VOS Collection

0:00Skin Anarchy Host:Hey guys, welcome back to Skin Anarchy. This is a very special episode because we're going to be diving deep into the world of medical aesthetic platforms and understanding like what goes on behind the scenes when it comes to the different practices that you might see from your favorite derms and doctors at large and just understanding that world of aesthetics. So without further ado, please welcome Dominic Mazzone, who is the CEO of VOS Collection. Welcome, Dominic. So excited to host you. Thank you so much for having me and obviously great to see you again as well. No, it's wonderful to connect.

0:31Skin Anarchy Host:And I'm so, so glad that you agreed to do this because this is a topic that I've never been able to like touch on on the podcast. And I know it's for a lot of people, like it's very difficult to understand. But before we go there, I really want to introduce our listeners to you and your wonderful background because your career is so impressive. So if you can walk us down memory lane and tell us what got you into business and the world of medicine. Well, I appreciate you. I appreciate that. Impressive is not the word that I would use. I would say it's been eclectic at best. So just, you know, from the start, I've been a serial entrepreneur since I was 16.

1:05So I started my first business when I was 16 years old. By 17, I was booking American bands in Tijuana, Mexico, which sounds like the craziest thing, but I was from San Diego. And again, I was an entrepreneur from the start and was doing that. So I've started and ran a lot of businesses, got a lot of corporate polish in the telecom world, which was good. Most entrepreneurs that I meet that never had actual corporate experience are wild. And I think, you know, being in the corporate world kind of ends up polishing off kind of the sharp corners. And so I would say that that was a fantastic experience.

1:40Skin Anarchy Host:But I have at this point started 19 businesses. Many of those were not great, but I learned from every single one of them. And, you know, the business, obviously, we're here to talk about today is Voss Collection. And what I, you know, for me, this is my favorite business. Why? Is it the most successful business? Yes. But it's also my favorite because this business is so much fun. This industry is so much fun. And a lot of times, like when you're starting businesses, you want to be able to go back sometimes and go, oh, I wish I started this way or wish I did it that way. I don't feel that way at all about this.

2:15I feel like I started this business with all the right intentions, with all the right principles and kind of philosophies from the very beginning. And I'm fortunate that that was the case. And because of that, we have such this incredible foundation, which is now Voss.

2:29Skin Anarchy Host:I mean, that's amazing, by the way. I mean, 19 businesses, all of that experience. I mean, it's really interesting because, you know, in the world of medicine, I think a lot of people know this, but a lot don't, that doctors don't get any training. You know, when it comes to the business side of running a practice, understanding how can you expand one day, you know, when you're not in the hospital anymore. All of these things are just never taught to us. You know, we never learn it. So seeing Voss Collection and what you've been able to accomplish and the way the tier of physicians that are, you know, working with you.

3:03Skin Anarchy Host:I mean, that is incredibly, incredibly impressive. And I'd love for you to actually start there is understanding like the business of medicine, the business of practicing medicine. And if you can kind of get us started, you know. Yeah, I just I think it's a really important point that I never really thought of until you just said, you know, doctors are never taught business. There's not a whole curriculum for that. But you know what's interesting is when it comes to entrepreneurs, there really isn't a curriculum around general EQ and understanding how to manage people and lead people and these types of things.

3:36You're never taught that. They try to teach it, but you don't really learn it until you do it. And I think when we think about the business of medical aesthetics as a platform, those types of things, I think what's happened and we see a lot around us is, you know, private equity comes in. They want to start a platform. They start buying stuff. They start rolling it up. They corporatize the living hell out of it. And it loses its mojo. And you end up a lot of times with that, with a lot of providers that end up being pretty unhappy as well because they are corporatized like crazy. I think for me, that was probably the most helpful in having all of my startup experience and build experience is I started with the first point of I'm not a private equity guy.

4:19I'm an entrepreneur. And what I was doing was out acquiring other entrepreneurs. And I had a really clear understanding of where that mindset is and what it means to start something and what it means to have your identity attached to it and what it means to say, well, oh, my gosh, I'm now going to sell this to somebody.

4:37Skin Anarchy Host:somebody? And am I going to lose what I built? And so what's been so helpful for me is those first principles of, okay, we're making an acquisition, but if I treat it truly like it's a partnership, then it's going to go back. Which by the way, they are partners. Like all of the physicians that have owned clinics in the Voss Collection, they all own equity in the Voss Collection. They're all shareholders. They're all my partners. But the difference is, is I actually treat them like partners. I really respect what they bring to the table. And I also very much respect their clinical freedom. And I think this is where private equity makes a huge mistake quite a bit, which is telling these incredibly talented individuals how to practice.

5:21I think that's a big mistake. And I think especially in aesthetics, because aesthetics is that just perfect combination of art and science. And first of all, telling a dentist how to practice is probably really tough. I've never had to do it, but I think that's really tough. Telling an incredibly talented aesthetic provider how to practice violates so many different things from a clinical perspective, but now you're also telling them how to do their art. And I think that's where private equity has traditionally made a massive mistake. What we've done is taken a very different approach and just said, okay, no problem.

5:57We're going to take all the things that people hate.

5:59Skin Anarchy Host:Bookkeeping. Nobody really likes bookkeeping. Nobody really likes HR or procurement or those types of things. Well, those are the things that we definitely will take a heavier hand in because that's what we know how to do. But when it comes to that patient showing up inside that room with the clinician, hands off. We don't tell people what products to use or any of those kinds of things. They have 100 % clinical freedom on what they want to do. And Our North Star is remarkable outcomes and results. That's all it is. So whatever it takes to get there, that's what we do to get there. And so to me, what I've seen from the data, and we are sitting on a treasure trove of so much data, is that clinics that are spending more time with their patients, introducing their patients to more treatments in combination to actually achieve fantastic results, has a direct correlation on the financial performance of that clinic.

6:55So what I would say is good outcomes and good results is actually good business.

7:00Skin Anarchy Host:No, that's really profound that you said that because this is where I think there's a huge level of just not understanding in the medical community about what it means for venture to come in and what that means for your practice as a medical specialist. You know, like that is the that's the big missing link, I think, in the understanding component. Because I'm not going to lie to you. I remember when I first graduated medical school, I was like, oh yeah, the people who have private practices, they're like sold out. You know what I mean? Like they're, I don't know, they've like kind of hung up the coat on the ethics part.

7:32Skin Anarchy Host:And it's not true. That's not true. You know? And I feel like that's where what you're saying is just so relevant to especially like newer physicians that are coming into aesthetics because aesthetics, when I look at aesthetics as an outsider, I see it as this is one of the hardest specialties, not because of the science and all the scores you need to get in, but because you have to always have that moral compass with your patients. And you have to always know that these are people who need help making decisions. Every patient does, you know? And like, I've had these countless conversations with some of the wonderful doctors that you work with as well, you know?

8:05Skin Anarchy Host:And they've actually reiterated this idea of like, no, like I have to sit my patients down and explain to them, this is what's going to move the needle for you. And this isn't. and talk about things like the golden ratio, talk about the, you know what I mean? All these things. And so I can't imagine a world where you have venture involved in a practice and they're telling you what to talk to your patients about, what products to push to them, you know, that kind of thing. So. Yeah. Sorry. So many things to unpack there, if I may just take 60 to 120 seconds to do that, which is, first of all, private equity has gotten a bad name in medicine for probably a really good reason, because many times it comes in and in the past it could have been heavy handed.

8:43And I even know in the world of medical dermatology platforms, as well as aesthetic platforms, giving the provider a quota. Wait a second. No one went to school to go get a quota. And that's not doing what's best for the patient. Right. And so what's best for the patient? That's just the North Star. Let's keep coming back to that. I think the other thing that's really important is sometimes it's funny, like we go into a practice and we're talking to the lead physician and they get to know us and they're like, oh my gosh, we know you and we know all your doctors. And oh my God, you have the deepest bench of globally recognized key opinion leaders in the world that are part of Voss Collection.

9:20We know you're great. Well, then sometimes we'll talk to an associate and the associate goes, well, I've talked to my other associate and they said private equity is bad. So I don't want that. And you know what? It probably is bad. I'm trying to culturally run the most un-corporate corporation I possibly can. That's my goal. From a standard operating procedure perspective, I'm trying to run a very tight corporation. But from a cultural perspective, I'm trying to do that. And my job and my team's job is to help facilitate all these incredible physicians and nurses and peers coming together and learning from each other and doing stuff.

9:55In fact, last night, I was the moderator hosted a webinar with Doris Day, Ava Shambam, Sue Ellen Cox, and Ellen Marmer. Amazing. our job to do that to create culture for a young physician or nurse or pa to come in and go i just got to watch an hour of the some of the greatest doctors in medical aesthetics talk to me about a very specific topic and i got that and why we only get that at voss collection but what's happened is what you find from these is that some of the greatest doctors in the world are like hey i I didn't know that. I never knew that. And so having that sharing and having that culture is what makes it great.

10:36Not it's a business and you're going to have a quota and I need you to sell X amount. That's not what aesthetics is all about. And that's not what's good for the patient. If you just focus on great results, literally everything else follows along.

10:50Skin Anarchy Host:That's I couldn't agree with you more. And that's amazing. I mean, those are some phenomenal names and very, very impressive. And that's what I mean is like, you guys are representing a different tier of this kind of a framework. I mean, this is a whole different level because the physicians that are on board are, I mean, they're just phenomenal professionals. I appreciate you saying that. And I know we were going to get into this, so maybe I'll just jump in if it's okay, is that the world of aesthetics has changed drastically in the last six years. Okay. We had 6 ,600 clinics in 2019. we now have over 13 ,000 clinics between the U.S.

11:26and Canada. Okay. We more than doubled, okay, in a very short amount of time. And when you double that fast, standards are going to be reduced. What we know in this industry is that there are not enough highly experienced providers that can actually provide great outcomes to fill all the new clinics that are out there. And what we identified is, I don't think I'm part of this industry. I don't think my folks are part of this industry. What we're part of is high-end, top-end results in medical aesthetics. That's what Voss Collection is. what we are not is, which I, you know, I really think is fair.

12:07I'm trying to be factual and not being opinionated is that 95 % of all clinics out there are running really a volume business. It's a lower cost volume business where we're going to just get people in the door. We're going to stick a needle in, we're going to get them in and get them out. And that's it. And I think that's fine. There's a place for that. And I think it's really important, but there is a differentiation between world-class medical aesthetics and getting world-class results than what is actually happening in the rest of the market. And that's why for me, really being able to come out with this platform and come out with this brand to help people know what good looks like and also to have them know, oh, I know that I can come to Boss Collection and get a source of truth.

12:49I can actually hear from some of the greatest providers in the world, giving me a source of truth on everything from neuro to filler to softwave work to tell me about bio stim and all these different things because we know there's a considerable amount of misinformation out in the market and we know there's a lot of lower tier clinics that maybe aren't providing people the best results that they possibly can get and so that's that's the mission right now no that's

13:17Skin Anarchy Host:actually i'm so glad you brought this up because i one of my big questions for you was this world that we're now seeing of like many spas and like just I mean, there's just so many different loopholes now in medicine that allow for professionals who might not be as credentialed, you know, as I mean, when I go to an aesthetic provider, I'm looking for an MD or a DO, like I'm looking for certain things. But there are a lot of people right now that are running clinics. And I think this conversation gets lost a little bit because we tend to create an umbrella understanding of like what it takes to become the best, you know, in a field like aesthetics.

13:52Skin Anarchy Host:I would love for you to speak about this in terms of you guys' vetting process when it comes to the clinicians you do work with, because I think that's also a very important piece of this puzzle of understanding like what makes that level of provider that's going to deliver exactly what you're talking about here, you know. So it's funny, in the background, I've been working on this article, okay? I've been working on this article. And by the way, I've been working on this art over like two months because there's so much in it and it's so important. And really what it's discussing is that the market is splitting up into two pieces, medical aesthetics and retail aesthetics.

14:29And this concept, I think, is really important because there is a place for both. I want to be super clear to everybody. So I'm not coming on your show and trashing all clinics that aren't part of Voss Collection. No, there's so many great clinics out there. But we have to start differentiating somehow for the patient to understand so they can make sure they can get what they need. And to me, like medical aesthetics has highly trained health care providers, right, that take more of a comprehensive approach considering all aspects. And because of that, they have all the technology that they need.

15:00They have all the expertise that they need. So you can actually get to quote Dr. Shannon Humphrey, who is also part of the Voss Collection, a 360 degree treatment approach. A really important thing. That's medical aesthetics. Retail aesthetics are more lightly trained providers that are doing the basics. And that's so great because people sometimes are like, I want to try Botox for the first time. And I don't know what to do, but I just want my 11s done. And hey, that's okay. Like, there are so many people that can do your 11s. That's really great. But at a certain point, some people are going to say, well, can someone help me with my skin?

15:38because I'd like someone to actually do something to help my skin because, you know, and of course, again, the typical analogy is like you've done all the body work on the car, but the paint is scratched up. And so I think there is a place for both, but we are starting to see that separation. From a Voss Collection perspective, we will never be 200 clinics, never. And we will never name all our clinics the same. No, we keep the brands, the brands of the clinics are the brands in the clinics. They're all part of Voss Collection. So our Marmor MD and Aesthetic Solutions with Sue Ellen Cox, those are all still there.

16:12Those brands are important and those are in place. We think that's critical, but those are fewer and farther between. And for us, we like to get large medical aesthetic practices that are primarily Dr. Rand. We have a few that aren't that are an exception, but they're pretty amazing. And for us, we want to make sure that a patient can walk in the door and get a complete comprehensive treatment plan and get treated in a way where they come out and go, oh my gosh, I have the most incredible results. They should be so excited when they walk out the door. And so we're very, very, very picky about how we do that because I think I have the pleasure of being one of, you know, maybe 10 or 20 people that have walked into the most medical aesthetic clinics anywhere.

17:06And I am so privileged to be able to do that because I've been able to sit back and watch. And by the way, like the first thing I look for is when I walk in one of those clinics, how am I greeted? Like how am I greeted when I walk in the door? If I walk in there and it feels like 1959 Russia, you know, where I'm walking into a medical building and I'm getting treated like you're lucky that you're here. Well, that's that's going to be gone. Like I have walked into a clinic and walked right out just because how we were treated. I was just like, no, I don't think I don't want to have to try to fix that because that's just not going to work.

17:45But the important thing is that we buy medical aesthetic practices, not retail aesthetic practices. And I just want to say one other thing. I've learned a lot over time and this is definitely more accentuated, I pick partners. And so if I walk in and I think, well, they're great at their job, but we can't get along with them. Or I don't think they're ethically all there. Or those kind of things, then we just turn it down. I have to like straight away, like you're not going to play well with the rest of everybody in the platform. And that doesn't work for us. And so it's really important that we really vet our partners like MAD to make sure that we don't hurt the culture that we've worked so hard to build in the first place that is helping to produce all these incredible results.

18:34I hope that answers your question.

18:36Skin Anarchy Host:No, it absolutely does. And I really, really applaud you because, you know, it's not just the culture you're creating within the company. It's a culture that you're propagating out into this industry, you know. And I think that's where the impact of Voss Collection for me stands out as somebody who's just looking at what you're building is that, you know, I've had countless conversations, Dominic, on the show about, you know, medical aesthetics and like where it's headed. And like, you know, obviously, like not the business, but like we were just talking about the medical part about all of it.

19:02Skin Anarchy Host:Right. And I mean, the conversations have involved like you were explaining the retail versus the aesthetic, like the differences. There was a movement for many years where people were walking into these like, you know, corner shop clinics, getting ridiculous treatments and then going to an actual aesthetic provider and saying, fix me because I don't know what I did, you know. And that's scary because that's where my heart goes out to all of these amazing physicians who've always been doing it right. You know what I mean? Because they end up getting stuck with these botched up jobs that they're like, now I have to actually introduce this person to real medical care.

19:37Skin Anarchy Host:Now it's on their plate to do that. And so that's what I mean is like what you guys are doing is setting a bar in this industry where it goes like, you know, you have to start thinking like, who are the people you're partnering with? It's not money. And I think that's where aesthetics also get such a bad reputation. And I don't understand, you know, sometimes because people say it's a money game. You know, it's all a money game. It's all about the business. It's all about how many people can you get through the door. But that's where I think there's a lot of debunking that needs to happen. You know what I mean?

20:06Skin Anarchy Host:In terms of like, no, it's not like that. There are people, some of the best doctors in the world are in aesthetics, you know, and they are not going to compromise. They're not like I spoke with Dr. Dayan, for example. You know, he's one of the most phenomenal surgeons I've ever met. And like somebody like him or like somebody like Dr. Day that you were mentioning, they will never compromise on their standards. And that by itself sets a bar, you know. So it's just so important what you're doing. I really, really appreciate it. I can say a couple of points on that. And Dr. Dayan was the first Voss Collection clinic in the U.S.

20:38So Steve is near and dear to my heart. We're buddies. and he's so influential in the industry and he's also so forward-looking. But you brought up a really important point and I just want to make sure I really get this out there. We are setting a bar. I want to set the bar. And I don't want to set the bar for just one reason, which one would think, oh, you want to set the bar, you want to differentiate yourself, you want to be the best of the best. No, that's all fine, I do. That's great. But if I can set the bar and that helps pull up the rest of the industry, or let's just say, because there's so many great clinics out there that are at that bar anyways.

21:12But there are so many, the majority are not. But if we can lift everybody up, what we end up doing is keeping patients in medical aesthetics. We end up keeping patients to say, oh, I actually got a good result. I'm not gonna not do this again. We want people, and the thing about us for Voss Collection, we're big enough where any bad outcome anywhere is bad for us. Forget even if it's a Voss Collection clinic or not, It doesn't matter. Bad outcomes in this industry is completely bad for everybody. And we don't want that. We want everybody to do well. And so it's really, really important to us that the industry as a whole lifts up and just gets better.